Say Goodbye to Surgical Scrubbing

       Surgical scrubbing means  doing a systematic routine of washing hands and arms following specific number of strokes. It involves lathering, soaking, and brushing one hand and arm and then the other. My students always do that before they start preparing the sterile field for the surgery. I remember doing that and counting the strokes in my mind at the same time.

       But when I when I went to duty last Monday, I noticed that the scrubbing area did not have that canister that contained the surgical scrub brushes. I looked for it but all the 3 scrubbing areas did not have that canister. I even thought that the staff of the previous shift did not just have the time to prepare it.

       Then, I was told that we were not using that anymore. There will be no surgical scrubbing done anymore in this hospital. Instead, a surgical handwashing solution replaces the surgical scrubbing procedure. All we need to do is wash our hands and our arms thoroughly with this solution and then we are already sterile enough to start wearing our surgical gown and gloves.

      
      Then I learned that hospitals from other countries also followed the same method. I was told that there are researches conducted which stated that surgical scrubbing breaks the integrity of the skin and predisposes us to infection. I will have to research on that to learn more.

       So, there will no be surgical scrubbing in this health facility. But still, the principle of Asepsis will be strictly followed.

Keeping things Sterile

When one goes on duty at the Operating Room, the most important thing to remember is to maintain the sterility of the sterile field and the surgical team doing the procedure. This means adhering to the Principles of Asepsis by heart.

Asepsis  means absence of pathogenic organisms. Keeping things sterile means not giving a chance for infection to happen while patients undergo surgical operation. But to be able to do this, one has to understand the principles behind it.

It frustrates me when I see medical practitioners that don't understand this. My students always look up to others who work at the Operating Room for a long time. If those whom they look up does not adhere to the principles, the students will adopt such ways. And it's sad because it does not only put the patient prone to infection, it has deprived the minds of my aspiring students of what is essential and ideal to peri-operative nursing.

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Principles of Asepsis

1.Only sterile items are used within sterile fields. All articles used in an operation have been sterilized previously.
 2.Persons who are sterile touch only sterile items/ areas; persons who are not sterile touch only unsterile items/ areas.
3.If in doubt about sterility of anything, consider it unsterile.
4.Nonsterile persons avoid reaching over a sterile field; sterile persons avoid leaning over unsterile area.
5.Tables are sterile only at table levels.
6.Gowns are considered sterile only from waist to shoulder level in front, and the sleeves.
7.The edge of anything that encloses sterile contents is unsterile.
8.Sterile persons keep well within sterile areas.
9.Nonsterile persons keep away from sterile areas.
10.Sterile field is created as close as possible to the time of use.
11.Sterile areas are continuously kept in view.
12.Destruction of integrity of microbial barriers results in contamination. Moisture can cause contamination.
13.When microorganisms cannot be eliminated, they must be kept to an irreducible minimum

Thoracotomy and Enjoying Operating Rooms

         At last, i have been assigned to be in the Operating Room. It has been 5 months now, and for the many times i have been marveled and awed by what I witness, it is just now that i blogged. The many things one could just imagine, is right before my eyes. And it has been "usual" already but the existence of such faculties never cease to amaze me.


        Like last weeks surgery was Thoracotomy. But in the many instances that I have witnessed such, it has always left me dazzled how the human body can be opened, the patient's chest for that surgery, without damaging other vital organs. That , when the chest right cavity was opened (which made abdominal cavity visible as well), you could actually see  the liver, diaphragm rise and fall as  the patient breathes. 
         It was like choreography at it's finest but we're not talking of a dance...it's real teamwork. The anesthesiologist, surgeon, nurses and students were so fast and careful..a vital thing for survival of a patient who know and feel nothing of what is done to him.
        And that amidst the opening, incising, cutting, suturing..it returned to it normal form once again..and much important, to it's normal functioning. 
       O well, i maximize what i see everyday and learn from it. It will always interest me as long as i'm there.